article in daily mirror.

Just wondering if anyone saw the article in the daily mirror today it reads as follows: HEART RISK IS50% HIGHER IN DIABETICS. Diabetics are 50% more likely to have a heart attack figures show today. Nearly 14,500 were victims in 2010 and 2011 4700 more than expected. Diabetes UK boss Barbara young said the figure was shocking and urged the NHS to focus on preventing heart disease in sufferers. She added " a large proportion of these heart attack could have been prevented through better education and care" the national diabetes audit also revealed 17,900 had a stroke 9,800 needed a kidney transplant or dialysis and 1,700 required s serious amputation. It found people with type two diabetes had a 36% higher chance of dying while the risk was 135% higher for those with the rarer type one there 3.7 million diabetics in the UK with an estimated 850,000 undiagnosed type two cases.

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Just as shocking as Diabetes UK's advice to eat starchy carbohydrates (it recommends 1/3 of your plate should be starchy carbs) and to aim for five portions of 'fruit and vegetables' a day, one portion for example being 'a banana or apple, a handful of grapes, a tablespoon of dried fruit, a small glass of fruit juice or fruit smoothie...'.

I also eat all those foods but can you imagine five portions of fruit a day? Like 5 glasses of fruit juice? Might as well have 5 servings of full-sugar Coke, it amounts to the same effect on blood sugar.

The point I was trying to make is that all this is kinda ironic. The original report makes the usual mistake of conflating 'diabetes' with 'uncontrolled diabetes'. Is it the simple fact of having diabetes that worsens health outcomes dramatically? Or is it the high, uncontrolled blood sugars due to uncontrolled diabetes?

Frankly, if I followed Diabetes UK's advice to fill 1/3 of my plate with starch and to have five portions of fruit a day, I'd also be having high, uncontrolled blood sugars and be straight on the path towards all these nasty health outcomes.

I can imagine, I prefer fruits more than any other food. Fruit juice...not so much - bleh.

the national diabetes audit also revealed" a large proportion of these heart attack could have been prevented through better education and care".

I suspect that is true, and with better education and care then would follow "control". I can't stand the words control or uncontrolled for diabetes. One day can be well controlled, the next a ride in the amusement park.

No matter what you eat there are ways to control your blood sugars. I happen to require insulin, even if I eat nothing. That is not controlling my condition, it is living with it.

If you look at the results of the EPIC study, men with an HbA1c of 5.5-5.9% had a CVD risk double that of those with an HbA1c of < 5% with age adjusted relative risk (adjusted for a number of factors including cholesterol).

For those why try to achieve good control this might be demotivational. Does it help anyone to read the cruel truth in statistical figures? Fear is the worst advisor you can have.

The real question is: Why do doctors still think that an A1c of 7% is fine? Even TuAnalyze shows the area from 6.5 to 7% as green. With all the evidence it should be yellow. An A1c of 7.5% is not a minimal miss of the target. It is an average of 164 mg/dl. Well above the kidney threshold leading to high amounts of tryglicerides in the blood stream. Still the medical community is treating it as a minor glitch in control. In contrast to its reputation and technical shortcommings the A1c can be a good guideline. All it needs are tighter targets and earlier adjustments of the treatment. This includes to switch people earlier to insulin treatments. One year of tight diets, sporty activity and loosing weight should be really sufficient to make this decision. Instead we see people being switched from one T2 medication to the other as if insulin is the last or worst choice to make.

From the Diabetes Hands Foundation blog...

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